NCPA - National Center for Policy Analysis


November 3, 2005

For a yearly cash retainer, patients can receive lavish health care from a new breed of "concierge" or "boutique" doctors, says the New York Times. Concierge doctors lavish time, phone calls and attention on patients using the latest in electronic communications to streamline their care.

How does concierge medicine work?

  • Concierge doctors charge fees as high as $10,000 a year, depending on services promised, but the majority charge $1,500 to $2,000; some practices operate on a cash only basis but generally those with lower annual fees still participate in Medicare or other insurance plans.
  • Basic services consist of same-day or next-day appointments and 24-hour telephone access to the doctor; the most expensive may also promise the doctor will make home visits, deliver medications and accompany patients on visits to other doctors.
  • The extra fees collected from patients let concierge doctors, who leave regular practice for concierge medicine, slash their caseloads which allows them to give fewer patients more time and attention.

Since its debut in 1996, concierge medicine has evoked criticism from many corners. Some ethicists say it is exacerbating the inequities in American health care. Insurance regulators have raised concerns about fraud. Government watchdogs, worried that it threatens the tenuous equilibrium of the health care system, are keeping an eye on trends.

The Government Accountability Office (GAO) issued a report in August 2005 stating that the number concierge physicians nationwide was still too small for the practice to limit Medicare patients' access to health care, but the government will continue to monitor trends.

Source: Abigail Zuger, "For a Retainer, Lavish Care by 'Boutique Doctors,'" New York Times, October 30, 2005; and "Physician Services: Concierge Care Characteristics and Considerations for Medicare," Government Accountability Office, August 12, 2005.

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